Provider Demographics
NPI:1861541971
Name:BULLINGTON, LEE A (DC)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:A
Last Name:BULLINGTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:STE D
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072
Mailing Address - Country:US
Mailing Address - Phone:615-851-2038
Mailing Address - Fax:615-851-8742
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:STE D
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072
Practice Address - Country:US
Practice Address - Phone:615-851-2038
Practice Address - Fax:615-851-8742
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U75630Medicare UPIN
TN3970818Medicare ID - Type Unspecified